How Would Male Birth Control Work?

The U.S. Food and Drug Administration approved the first female birth control pill in 1960. Within two years, more than 1.2 million American women were using this method of contraception, commonly called “the pill.”

In 2022, when a landmark judgment ended the constitutional right to abortion in the United States, inquiries about vasectomies skyrocketed as men stepped up to share the responsibility of contraception and play a more active role in reproductive health along with their female partners.

At the same time, there has been a renewed interest in the “male pill” as a method of male contraception.

Please continue reading to learn more about when male contraceptives might become available, how they would work, and whether they will effectively prevent pregnancy.

Is there a male birth control pill?

There is currently no male birth control pill available. However, as part of the male contraceptive development program, several drugs are in clinical trials.

When they become available, reversible male birth control options (hormonal birth control) will offer an additional contraceptive option to men and their partners. Currently, condoms and vasectomy are the two main methods of male contraception available. The withdrawal or pull-out method is considerably less reliable.

Vasectomy reversal is possible, but it is considered a permanent form of sterilization in men. Reversible hormonal birth control for men will help to overcome post-procedure regret, which is a key hurdle in encouraging men to get a vasectomy.

Condoms create a physical barrier and prevent sperm from reaching the vagina. They are effective, but many men and their partners dislike using condoms. A male contraceptive pill could provide an alternative to condoms. However, unlike condoms, a male pill will not protect against sexually transmitted infections.

How would male birth control pills work?

Most of the male birth control methods under development would work by affecting sperm counts. Some of these drugs lower testosterone production and thereby affect sperm production.

Why was male birth control discontinued?

The World Health Organization (WHO) conducted trials of testosterone as a male contraceptive in the 1980s and 90s. Testosterone was found to be highly effective in suppressing sperm production at its source. However, it needed to be taken at high doses to be effective. This led to intolerable side effects like acne, weight gain, mood swings, and irritability.

Interestingly, these are well-documented side effects associated with hormonal birth control pills for women. Female birth control pills are additionally associated with more serious adverse effects like blood clots and high blood pressure.

Nonetheless, research into testosterone and progesterone as a male birth control was discontinued due to serious side effects like severe acne, pain in the penis, and depression.

When will male birth control be available?

Here are some of the drugs in clinical trials which, if approved, will give men a reversible option for family planning.

NES/T (Nestorone/Testosterone)

This is a hormone-based birth control for men that is in Phase IIb trials. It is a clear gel that is applied daily to the shoulder blades and works by inhibiting sperm production. It also helps in maintaining sexual drive and sexual function and may help men with low libido and erectile dysfunction.

NES/T is a reversible male birth control method. Sperm levels return to normal in approximately 4 months after stopping use of the gel.

If it moves forward, NES/T will be the first male birth control product to enter Phase III trials in the US. It is difficult to say how long the process will take as this will be uncharted territory for male contraception.

DMAU and 11-beta-MNTDC

These are two experimental male contraceptive pills that belong to a group of drugs called progestogenic androgens. They work by lowering testosterone production, which in turn lowers sperm count. Around 75% of men enrolled in a study investigating these drugs report that they found the side effects acceptable.

YCT529

This is a birth control pill that researchers at the University of Minnesota have found is 99% effective in preventing pregnancy in mice. It works by decreasing sperm production and fertility. The effects of this daily pill are reversible within 4-6 weeks of stopping use in mice.

It remains to be seen whether this drug will proceed through the clinical trial process to human trials. If it does, YCT529 will become one of the first oral contraception options that will lower a man’s ability to father biological children. Experts remain skeptical, however, and say we should not expect a widely available male birth control pill anytime soon.

Adam

Developed by a biotech company in Virginia called Contraline, this is an injectable hydrogel that is awaiting clinical trials. It lasts for one year and is called the IUD for men. If approved, Adam may provide one of the few long-term birth control options for men.

Reversible Inhibition of Sperm Under Guidance

This is a non-surgical procedure under investigation in India. It involves injecting a gel into the vas deferens (the tubes in the penis that store sperm).

How effective is male birth control?

A vasectomy is the most effective male birth control method, with success rates of over 99%. Only 1-2 couples out of 1,000 get pregnant within a year of the male partner getting a vasectomy.

Condoms have 98% effectiveness in preventing pregnancy when used correctly every time you have sex. Around 2 out of 100 couples get pregnant within a year if they are using condoms as a method of contraception.

The withdrawal method (pulling out before ejaculation) has the highest failure rate in pregnancy prevention. Around 1 in 5 couples get pregnant within a year with this method of birth control.

Wrapping up

Research is ongoing, and more birth control options for men may become available in the future, including a male birth control pill. Most of these methods would work by lowering levels of sperm in the semen. However, longer randomized control trials are needed to establish the safety and success rate of these birth control options. At the current time, it does not appear that male birth control pills will become easily accessible anytime soon, however, a vasectomy is a good surgical option to consider.

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